Laserfiche WebLink
� i� <br /> . ., � . � ' � � . <br /> i <br /> s�: <br /> WOOD BURNING EOUIPMENT <br /> Wood stove with flue <br /> Wood combination or add-on <br /> Factory fireplace with flue <br /> Factory Fireplace (s) Freestanding Masonry <br /> Wood Stove (s) Franklin, other <br /> Brand Name Model No. <br /> Mfgr's Min., Clearances, side, , rear , min. flue dia. <br />` Total <br />�-:,: <br /> VENTILATION <br />' �' No. Kitchen Exhaust ducted recirculating cfm <br />`�':' No. Bath E�aust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm <br /> Total <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> Fuel oil: gallons underground inside outside <br /> LP Gas: gallons <br /> `' Other Gas opening <br />:sA_ <br /> PERMIT FEE CALCULATION <br /> " 1. 1.25% of Contract Price* or Minimum Fee ($35.00) -? �' <br /> , , � ;, �__----__ - S � �� <br /> � :� �� r-, � �� x 1.25 $ ; � J <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Building Code Division _ _ <br /> 1 ' :,. <br />�;��� Surcharge to each permit. x .0005 $ <br /> (contract price) <br /> 3. Postage and Handlin� (Only mail-in applications) $ 1.50 �J� � �S <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ��- �=°-��— <br />�.. 3 � �5- <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted <br /> �ver�C including materials, labor, nrpft, anc� �ther fixPd costs. It is the amo>>nt to be charged to the <br /> customer for the work done. If any material, equipment, labor, or installation are furnished by the owner, <br /> tenant or any other party the reasonable market value of such items must be added to the estimated cost <br /> or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, <br /> the City may request the submission of a signed copy of the actual contract. <br />��" <br /> x� ** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is <br /> t' greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do <br /> all work in strict accordance with the ordinances of the City and the regulations of the Minnesota <br /> State Building Code, and certifies that all statements made on this application are complete, true <br /> and conect. �� r- , -, �� <br /> ��� � � <br /> r . <br /> Applicant's Signature: � � ��-E�-�--�- Date: '-� =�- 2 - `� 3 <br /> Approved By: � Date: --� `� <br /> F: <br /> � , <br />